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'MANPOWER FOR TI-E MEDICAL LABORATORY. THE NATIONAL CONFERENCE ON EDUCATION AND CAREERDEVELOPMENT OF TIC NATIONAL COMMITTEE FOR CAREERS IN MEDICAL TECI-1'IOLOGY (UNIVERSITY OFMARYLAND, OCTOBER 11-13, 1967). SUMMARY REPORT.

Department of Health Education and Welfare. Washington D.C.; National Committee for Careers in MeacalTechnology. Washington D.C.

Pub Date 68Note- 23pAvailable from- Superintendent of Documents, US Government Printing Office, Washington D.C. 20402(PHS-177130.

EDRS Price t4 TS0.25 HC Not Available from EDRSDescriptors-*JUNIOR -COLLEGES MANPOWER DEVELOPMENT, MEDICAL LABORATORY ASSISTANTSOCCUPATIONAL 'MOBILITY, -*PARAMEDICAL OCCIPATIONS, *PROFESSIONAL OCCIPATIONS, SCIENTIFIC

-MANPOWER SUBPROFESSIONALS *TECI-INICAL EDUCATION TRAINING, VOCATIONAL EDUCATION

The ,coAference oblectives were to review the forces that are changing-manpower fieeds and to seek ways of staffing medical laboratories more effectively.Seven aspects of the problem were treated: (1) need for detailed analysis ofpersonnel-needs (2) effects of technology and automation on laboratory practices, (3).:attracting, -educating, _and retaining qualified personnel, (4) achievement of .

higher7quahty --education and training (5) ways of keeping up to date, (6) careermobilty and -_equivalency, and (7) certification and licensing of personnel and.accreditation of school% Some of the recommendations made were: (1) reassesscareer and -- -training categories, (2) formulate a system for nationwide workload-reporting, (3) rtscruit from such aled fields as chemistrr and- physics, (4) -help colleges--with 'their --medicartechnology_ courses,_(5) encourage 4-year schools to strengthen

. -their biccalaureate -arid, graduate programs (6) improve and coordinate continuing-.--educationi--(7advise -use of self-teaching media to save instruction time (8) develop-equivalendy_!Jetts,: to increase mobihty. between categories and levels, (9) provide-licensing agencies:With-both scientific and public advisors, and (10) establish a nationalaccreditaticin agency. (1-1HY -

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U.S. DEPARTMENT OF HEALTH, EDUCATION & WELFARE

OFFICE OF EDUCATION

THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE

PERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OR OPINIONS

STATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDUCATION

POSITION OR POLICY.

maim(' erfor themedical laboratoryTHE NATIONAL CONFERENCE ON EDUCATION ANDCAREER DEVELOPMENT OF THE NATIONALCOMMITTEE FOR CAREERS IN MEDICAL TECHNOLOGY

October 11-13, 1967

A SUMMARY REPORT

Sponsored byNational Committee for Careers in Medical Technologyand theCancer Control Program, National Center for Chronic Disease Control,Public Health Service, U.S. Department of Health, Education,and Welfare

With the cooperation ofNational Council on Medical Technology EducationBureau of Health Manpower, Public Kealth ServiceNational Communicable Disease Center, Public Health Serviceat theUniversity of Maryland Center of Adult EducationCollege Park, Maryland

=

UNIVERSITY OF CALIF.

LOS ANGELES

For sale by the Superintendent of Documents, U.S. Government Printing OfliceWashington, D.C. 20402 - Price 20 dents

AY 2 4 136-8

CLEARMIGHOUSEFOR

JUNIOR COLLEGEINFORMATION

Proceedings of the conference will be published later this year, and may be obtained byaddressing Superintendent of Documents, U.S. Government Printing Office, Washington,D.C. 20402.

Public Health Service Publication No. 1771

CONTENTS

PLANNING COMMITTEE AND CONSULTANTS Page 4

THE CONFERENCE FORMULA page 5

LETTER FROM THE CHAIRMAN page 6

CONFERENCE OBJECTIVES page 7

CONFERENCE HIGHLIGHTS AND RECOMMENDATIONS page 8

REPORT OF THE CONFERENCE page 15

Excerpts From Speeches page 15

Excerpts From Symposium page 16

Discussion Groups page 17

Congressman's Remarks page 18

ALPHABETICAL LIST OF PARTICIPAN1S page 19

SPEAKERS, SYMPOSIUM MEMBERS, DISCUSSION GROUP LEADERS page 22

PLANN INGCOMMITTEE

ROBERT W. COON, M.D., Chairman National Committee for Careers in Medical Technology;Chairman Department of Pathology, College of Medicine, University of Vermont

NELLIE MAY BERING, MT(ASCP), Teaching Supervisor, Schools of Medical Technology,Doctors and Sibley Memorial Hospitals, Washington, D.C.; Membtr of Board of Schoolsof Medical Technolgy, ACSP

Rirrhi F. HOVDE, MT(ASCP) MS, Professor and Director, Division of Medical Technology,University of Minnesota

MARTHA PHILLIPS, MT(ASCP)MS, Chief, Grants Review Branch, Division of RegionalMedical Programs, National Institutes of Health, U.S. Public Health Service

SISTER M. ROSARII, MT(ASCP)MS, Secretary, Board of Certified Laboratory Assistants,ASCP; Board of Directors, ASMT; Teaching Supervisor, CLA School, Little Companyof Mary Hospital, Evergreen Park, Ill.

W. B. STEWART, M.D., Chairman, Board of Registry of Medical Technologists, ASCP(1964-67); Chairman, Department of Pathology, College of Medicine, University ofKe ntucky

MERLIN L. TRUMBULL, M.D., Commissioner of Medical Technology (1963-67), ASCP;Director of Laboratories, Baptist Memorial Hospital, Memphis

MARJORIE WILLIAMS, M.D., Director Department of Pathology and Allied Sciences, VeteransAdministration, Washington, D.C.

CO N S U LTA NTS HOWARD L. BODILY, Ph. D., Chief, Division of Laboratories, California State Health Department

FRANK G. DICKEY, Ph. D., Executive Director, National Commission on AccreditingFREDERICK K. ERICKSON, Acting Director, Division of Allied Health Manpower, Bureau of

Health Manpower, U.S. Public Health Service

NORMAN HOLLY, Special Assistant for Health Economics, Bureau of Health Manpower, U.S.Public Health Service

THOMAS D. KINNEY, M.D., Senior Consultant on Pathology, National Institute of GeneralMedical Sciences, National Institutes of Health; Chairman, Department of Pathology,Duke University

U. PENTTI Koxxo, M.D., Chief, Laboratory Program, Communicable Disease Center, U.S.Public Health Service

MARY S. RESH, Deputy Assistant Manpower Administrator, U.S. Department of LaborEDWIN F. ROSINSKI, gd. D., Deputy Assistant Secretary for Health Manpower, Department

of Health, Education, and Welfare

WILLIAM L. Ross, M.D., Chief, Cancer Control Program, National Center for ChronicDisease Control, U.S. Public Health Service

REX D. COUCH, M.D., Project Director; Chairman, National Council on Medical TechnologyEducation; Department of Pathology, College of Medicine, University of Vermont

DALLAS JOHNSON, Coordinator; Executive Secretary, National Committee for Careers inMedical Technology

THE CONFERENCE FORMULA

II

This interdisciplinary conference on "Manpower for the Medical Laboratory" was con-cerned with personnel below the level of laboratory director. The positions under consid-eration included the three principal categories of certified personnelmedical technologists,cytotechnologists, and laboratory assistantsas well as other professional and associatedstaff members such as chemists, biologists, technicians, and aides.

The program included (t) keynote addresses and a symposium to provide informa-tion about the conference background, objectives, and discussion questions, and (2) eightdiscussion groups concurrently held to study and seek suggestions and solutions for prob-lems related to manpower for the medical laboratory.

Participants were assigned to groups related to their interests, with several disciplinesrepresented in every discussion group. Each participant was provided a background papercontaining pertinent information and oudining key questions and issues related to thediscussion topic of his group.

In addition to the background papers, conference participants received resource bookscontaining reports, tables, charts, pamphlets, article reprints, and special studies on labora-tory personnel. The contents covered: Supply and Demand of Personnel, Federal Legisla-tion, Education of Laboratory Personnel, Licensure and Certification, Health ManpowerStudies. Some of the materials specially prepared for the resource book are included inthe appendix to the conference proceedings.

Each discussion group had a moderator, an assistant moderator, and resource personsexpert in the discussion topic. Experienced reporters were assigned to report objectivelyeach group's deliberations and recommendations.

5

NATIONAL C4MMIT TEE FORCareers in Medical Technology1501 New Hampshire Avenue, N.W.,Washington, D.C. 20036

executive secretary DALLAS JOHNSON phone ADsame 4.8842

Sponsors: AMERICAN SOCIETY OF MEDICAL TECHNOLOGISTS THE AMERICAN SOCIETY Of CLINICAL PATHOLOGISTZ' COLLEGE Of AMERICAN PATHOLOGISTScommittee: ROBERT W. COON. CHAIRMAN VERNA RAUSCH. MT (ASCP) HS. VICE CHAIRMAN JOHN I.. GOFORTH. M. D.. SECRITARYTREASURER WILLIAM CHRISTOPHERSON. MS

SARA MARIE CICARILLI. NV (ASCP) SIR MARD F. MAN N. JR.. M.D. CLAN INCE A. NC vniontut. N.D. WARM J. WALLACE. MT (ASCP) 1110151 Z. WILLIAMS. M.D.consultants: GROSSE P. VIIIMART. M.D.. GOARD OF REGISTRY OF 1110ICAL TECHNOLOGISTS ILWOOD I. PAM). 11.0.. BOARD OF SCHOOLS OF MIDICAL TICHNOLOGY

SISTER M. ROSARIO. NT (ASCP) NP. SOAR() OF cEitmito LASOMATORY ASSISTANTS JOAN onotimoven. NV (Aso) CHAIRMAN. NATIONAL RECRUITNINT COMMITTRI. ASSITRUTH HES ET (ARCO. CHAIRMAN ASHY IDUCATION RISEARCH FUND. INC. CAPT. ISRUCI FORCES INSTITUTI OF PATHOLOGY

January 2, 1968

In the evolution of medical laboratory practice, social, economic,scientific and technological forces are demanding the serious attentionof all concerned. Medicare, Medicaid, group health practices, RegionalMedical Programs, centralization of laboratories, automation and electronicsin laboratory processes and an enormously increasing' demand for tests andservices are creating such forces today.

The responses of laboratory medicine to there forces will affect profoundlythe recruitment, educatiom and careers of laboratory personnel. To assureimprovement in quality of laboratory service and patient care, as the newstaffing patterns develop, all groups engaged in laboratory medicine mustseek wisdom in planning and coordination in action.

This need has been impressed upon the National Committee for Careers inMedical Technology in its efforts to recruit personnel and its studies ofmanpower and training pnoblems. The Cancer Control Program of the PublicHealth Service arrived at a similar conclusion through its support ofcytotechnology training and of experiments in graduate and continuingAucation for medical technologists.

As a result, the Natiomal Committee contracted with the Cancer ControlProgram to conduct this interdisciplinary conference on Manpower for theMedical Laboratory. The conference was held October 11 through 13, 1967,at the Center for Adult Education, University of Maryland. Two hundred ofthe nation's leading pathologists and medical technologists, clinicalchemists and microbiologists, public health and manpower specialists,occupational analysts9 hospital administrators, educators and testers,scientists and economists were there.

As a next step, the Conference Planning Committee urges immediate estab-lishment of an interdisciplinary task force to implement the conferencerecommendations and proposals.

CONFERENCE OBJECTIVES

The overall objective of the conference was to provide opportunity for members of thevarious disciplines concerned with training and utilization of medical laboratory personnelto (1) review some of the forces that are changing manpower requirements, and (2)explore ways of staffing medical laboratories that will serve America's health needs moreeffectively.

This broad directive was expressed as:

* Identifying laboratory personnel requirements as affected by changing demands of healthcare and distribution of services

* Analyzing the effects of technology and automation on present and future laboratorypersonnel needs

* Examining ways to attract, educate, train and retain qualified laboratory personnel

* Exploring career mobility and equivalency.

* Studying certification and licensure of personnel and accreditation of schools

7

CONFERENCE HIGHLIGHTS ANDRECOMMENDATIONS... A compilation based on significant statements and suggestions ofconference speakers, symposium members, and discussion groups. Therecommendations have been reviewed and approved by the ConferencePlanning Committee. Most recommendations evolved from group discus-sion and combined thinking and cannot be individually attributed. Theyare presented in the order in which conference objectives were stated,without implications of priority or urgency.

It is incumbent upon all leadership groups to make sure that you don't get stuck withthe patterns that served you well in the past, but that you develop the flexibility to come outwhere it makes sense to come out a decade hence.

EU GINZBERG, PH. D.Conference participants, in the spirit of Dr. dinzberg's challenge, sought to identify out-moded practices of the past and to formulate new patterns alined to the changes to comein laboratory staffing, personnel utilization, and standards of education and training. Thatsuch training and staffing patterns must be continuously reassessed as technological andsociological forces shape and reshape the future scene was made clear in conference speechesand discussion.

NEED FOR INFORMATIONReflected throughout the conference was the need for a complete, detailed analysis ofpersonnel requirements for operation of a modern clinical laboratory in terms of thcfunctions performed and the technical and professional skills required for such performance.From this stemmed three related recommendations.

Recommendation 1: There is urgent need for a study to determine and define skills and manpowerrequirements for present and future medical laboratory practice, with considera-tion of anticipated changes in laboratory methodology, demands for laboratoryservices, and organization, administration, and delivery of laboratory services.

The study should be conducted by professional analysts. It would serve as a foundationupon which future determinations and estimates could be drawn. Activities based on otherconference recommendations could be initiated concurrently with the study of job descrip-tions and skills.

Recommendation 2: Findings of the study of necessary skills should be employed to reassess andrealine laboratory career categories and the educational and technical levelsrequired for the categories.

Determination of the education, skills, and judgment required to fill medical laboratoryroles is of paramount importance not only in education and training of laboratory personnelbut for the nationwide recruitment efforts undertaken to meet laboratory manpower needs.

Recommendation 3: To measure and project manpower needs accurately, a uniform laboratory work-load reporting system should be formulated and adopted nationwide.

A standardized national reporting system could be developed by coordinating theseveral systems presently used by professional and government organizations involved inlaboratory medicine. Following development of a uniform system, the professional organiza-tions should promote its universal adoption and use and periodic updating of its components.

1

EFFECTS OF AUTOMATIONAutomation and computer applications in laboratory medicine are causing a technologicalrevolution that will profoundly affect manpower-requirements. The coming changes willrequire a high degree of competence and specialization within existing disciplines and theintroduction of new disciplines to the field.

Recommendation 4: An analysis should be made of the need for new specialties and disciplines in theclinical laboratory, and of the curriculums and training to be developed to preparepersonnel for the new roles.

Examples of new types of laboratory specialists that may be needed are servicemenwhose military electronic experience can be adapted to use in the clinical laboratory, andsystems analysts, data processing personnel, and ether graduates of technical and engineer-ing schools.

New courses for laboratory employment might include biomedical equipment opera-tion, already the subject of pilot curriculum studies; biomedical engineering at technicianand Postgraduate levels; electronics; computer programing; isotope technology. Somecould be taught in junior and community, as well as 4-year, colleges.

It was recommend, I that, in establishing new laboratory specialties, staffing patternsshould be kept flexible and reviewed regularly to consider new titles, new opportunitiesfor different types of personnel, and new responsibilities.

ATTRACTING AND RECRUI TING MANPOWERCompetition for talent has put recruitment on stage, front and center. * * * Those whoare determined that the health careers shall have a fair share of the Nation's top talentwill have to accept the fact that competition is a permanent part of the recruitment process,

and make the most of it.KEVIN P. BUNNELL, ED. D.

Recommendation 5: Allied health careers should be promoted by directing information on laboratoryas well as other health careers to science teachers, guidance counselors, librarians,parents, and students starting as early as upper elementary grades.

Career information should be offered as a joint exposition of the roles the various workersfill in patient ca:e, leaving the student to decide which best matches his interest. Coopera-tion with health career councils can help direct attention to medical teamwork and toscience courses preparatory to medical care and research. The combining of career oppor-tunities may help offset the competition with other science fields for manpower.

Recommendation 6: Recruitment efforts should be directed to new sources of manpower.Medical laboratory careers must appal to a broader range of aspirations and abilities

than is the case at present to meet the needs at all levelsi.e., scientists, technologists,technicians, and assistants.

It was urged that clinical laboratories recruit and welcome to their field more scientiststrained in the fields of chemistry and physics. With these individuals responsible forobtaining scientific data and supervising automatimi, medical technologists could concen-trate on areas related to patient care in which judgment provided by medical orientationis needed.

Others who with proper preparation could serve in the medical laboratory: (1) Econom-ically and educationally underprivileged persons with ability and talent; (2) handicappedindividuals whose disabilities do not preclude laboratory work; (3) inactive medicaltechnologists; (4) married women with science backgrounds who want to enter or reenterthe labor market; (5) older age groups with interest in science, induding retirees r-ithadaptable skills; (6) persons with outmoded technical skills whocan be trained.

Specific efforts should be aimed at recruiting armed-service veterans who receivedtraining in military laboratory programs, as well as those with experience in electronics.

9

Low salaries and lack of prestige at the levels for which they qualified have deterredveterans from seeking civilian laboratory jobs. Dr. Eli Ginzberg said on this: "You musttake advantage of the male manpower who have somelackground interest and competencein your area. That means that you must look very carefully at too rigid educational quali-fications for certifications and promotions. Or you must build in an easier system for themto pick up their undergraduate degrees."

It was proposed that men leaving military service be provided with information onlaboratory careers, and encouraged to use GI bill benefits to obtain the education andtraining that will qualify them for satisfying laboratory positions.

EDUCATION TO THINKIf you only train somebody, he may well be left out in the cold if you introduce new pro-cedures and new techniques a * * if, however, he has been educated to think, he hasacquired certain patterns of thought, certain ways of establishing qualitative judgments,and therefore has the background to live with change and himself encourage improvement.

CALVIN PLIMPTON, M.D.

Recommendation 7: Laboratory professionals should cooperate with educators and science educationgroups to help upgrade the quality of science education in elementary and highschools:

Participation by laboratory personnel in Science Fair projects is one method of offeringcooperation to science teachers and of demonstrating the relationship between sciencecourses and health careers. Other joint efforts between laboratories and educators mayfollow such preparation.

Students in rural and overcrowded urban schools are often barred from health careersbecause of poor preparation in science. Special courses could be developed to help studentswithout adequate science backgrounds enter medical laboratory training and jobs. Suchcourses might be given in mobile laboratories, summer courses, and in junior colleges;as refresher programs, correspondence courses, over closed-circuit television, or as programedinstruction.

A general improvement in the quality of science education might be effected by stress-ing its importance in the laboratory career information directed to elementary and inter-mediate levels, and often seen by school officials and parents.

The community college movement is growing at a rate which is hard for most peopleto comprehend. As new colleges are founded, you a * * will want to assure yourselvesthat the health professions are adequately represented in the curricula of these institutions.More specifically, you will wan: to be sure that quality courses and programs supportiveof the medical laboratory careers are available.

KEVIN P. BUNNELL, En. D.

Recommendation 8: Assistance and guidance should be provided junior colleges and vocational schoolsin developing educational programs leading to medical laboratory careers.

Courses of sound academic quality related to medical laboratory skills, such as gen-eral biology and applied mathematics, chemistry and physics, are needed in junior andcommunity colleges if they are to produce medical laboratory personnel. The advantagefor laboratory careers of developing courses that permit transfer of junior college credit to4-year baccalaureate programs was stressed, as well ai the importance of informing studentsentering terminal junior college programs of such courses' limitations in terms of futuremobility.

Exactly where terminal graduates of junior and community colleges will fit in thelaboratory of the future remains uncertain pending the recommended study of the knowl-edge and skills required for different assignments. The possibility of training these grad-uates specifically for general duty in small community hospitals was suggested. It was

10

recognized that minimal if not nonexistent supervision in such situations makes thisproblematical.

Dr. Ginzburg put forth the controversial proposal that science requirements formedical technology might be "squeezed into the junior college" by asking: "What partof your educational requirement is real and what part is spurious or snobbish?"

Recommendation 9: Colleges and universities should be encouraged to strengthen baccalaureate cur-riculums for medical technology education, and the current 3-year college plusI-year clinical trainine system should be reviewed.

It was pointed out that .professional personnel in medical laboratories will increas-ingly need education for flexibilitythe ability to acquire skills not yet identifiedtoadjust to rapid changes in services, procedures, and skills required.

The importance of improving medical technology education in both the academic andclinical areas was stressed by Leanor Haley, Ph. D., MT(ASCP), in criticizing medical tech-nology programs that "do not stimulate students, offer no challenge. We end up in manyinstances with rote workers * * * who cannot do work that we are going to have to doin the laboratory." She suggested that partial solution, could come from the establishmentof Colleges of Allied Health Professions, which offers "a new approaeh to the training o(medical technologists. We get them earlier and we can set up a whole new curriculum."

Also suggested was development of core science courses for all college students pre-paring for health fields. This would permit joint use of faculty and laboratory facilities,strengthen recognition of the health team concept, and allow for mobility between healthcareers.

Development of guidelines for meaningful affiliation between colleges and universitiesand the clinical hospital schools affiliated with them was strongly recommended. If theclinical year of training is to be recognized by graduate schools as a bona fide college year,clinical and academic programs must be more closely coordinated to assure in educationallysound experience. .

While it was recommended that teachers of laboratory personnel should devote majortime to teaching responsibilities, it was felt that they should also retain some role in thelaboratory to keep in touch with day-to-day activities.

Recommendation 10: Graduate education for medical laboratory personnel should be strengthened andexparded.

.

Increased graduate opportunities will lead to positions with greater responsibility,higher salaries, and more prestige for medical technologists, and will attract persons ofhigher ability and talent to the field. Gradinte programs were recommended in immuno-chemistry, genetics, and other sciences for specialists; in administration and systems manage-

- ment for supervisors; in educational methodology for teachers.Increased numbers of scholarships for graduate study by medical technologists were

suggested, as was the establishment of scholarships to make it possible for a few medicaltechnologists to attend medical school.

LEARNING TO KEEP UP TO DATEThe essence of continuing education is helping people to grow * * * lt is associated with aspirit of curiosity. lt is important that the institution have this attitude of curiosity. It istypical of the attitude of good physicians, good technologists, and this attitude will be mostresponsible for progress in the future.

CALVIN PLIMPTON, M.D.

Recommendation 11: Continuing education programs for medical laboratory personnel should be ex-panded and strengthened, and better methods for coordinating and evaluatingthem developed.

Continued acquisition of knowledge and expertise by laboratory personnel at all levelsis essential. An inventory and clearinghouse of continuing education courses would help

11

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coordinate them and bring them to the attention of additional personnel. Evaluation of con-tinuing education courses should be assigned to a responsible agency.

An eniightenment program on the value of continuing education might motivate lab-oratory directors and hospital administrators to adjust working schedules to provide stafftime for courses, thereby stimulating wider participation. Establishment of in-service pro-grams, such as seminars, educational staff meetings, instruction on new developmeats andmethods, during working hours, was recommended.

It was suggested that grants be made to encourage medical centers to provide post-graduate continuing education courses, including instruction on how to conduct continuingeducation programs that would generate satellite programs. The Public Health Serviceshould be encouraged to augment grants-in-aid programs such as those for advanced medi-cal technology traineeships under the Allied Health Professions Personnel Training Actadministered by the Bureau of Health Manpower, and the support for graduate studyinitiated by the Cancer Control Program.

Members of one discussion group urged that the Bureau of Health Manpower seek theadvice and assistance of the medical laboratory field in coordinating Government programsrelated to continuing education for this field as well as for the allied health professions ingeneral.

Is it really necessary for teachers to mouth what has already been iiut into print? Attitudesare another matter. Ilow to sterilize a syringe is different from making sure the syringe issterilized before it is used on a patient. These simple attitudes and the more sophisticatedones can only be taught by contact with the competent instructor. GEORGE A. WOLF, M.D.

Recommendation 12: New curriculums and teaching methods should be explored, with experimentationencouraged, and self-instruction in laboratory education should be utilized moreeffectively.

If clinical work is to be part of the degree requirement, affiliated colleges and universi-ties should more closely integrate academic study and clinical experience, in line with theideas presented under recommendation 11, and the colleges and universities should takemore responsibility for the total educational experience. The possibility of programing theclinical training after 4 years of college or as an integral part of the baccalaureate programwas raised.

Dr. Wolf pointed out that substantive information can be learned from .books, filmstrips, teaching machines, closed-circuit TV, and other tutorial aids. These self-educationmedia should be exploited more fully to help students acquire information and developskills on their own, to bring their knowledge up to the point where the skilled teacher ismost effective.

A further recommendation was that outmoded rules on educational qualifications bemodernized, rigid reliance on clock hours or course units being replaced with more effectivemechanisms for demonstrating competence. Creation of more flexible examining systemsmight increase experimentation and progress in education and. training.

MOBILITY AND MANPOWERW herever we have a profession with a compensation structure which is rigid * * * wherethere is no place to go at the top, recruitment of talented individuals will be difficult.

E. R. JENNINGS, M.D.

Recommendation 13: Career opportunities in medical laboratories should be improved, and financialrewards provided at the top that will attract and retain more professional admin-istrators and other specialists.

Low salaries are a major recruitment deterrent. They tend also to make for a pre-dominantly female work force, a situation Dr. Ginzberg called unhealthy in its effects oncareer continuity and its drag on wage rates.

Entering salaries should be at least comparable with those of other professions requir-

12

ing similar education and proficiency. Salary schedules should offer a series of levels based

on competence and responsibility that enable qualified technologists to move into super-visory and administrative positions up to a suggested position of assistant clinical director.

There should be a reasonable number of positions at the level of $15,000 and above.Efforts should be made to insure effective utilization of laboratory personnel and ade-

quate opportunities for advancement. Personnel trained and employed below their capa-bilities should be able to obtain education or training leading to higher positions without

starting in again at the bottoin of the academic ladder. Educational programs should be

designed so that students who do not want to stop at given points in the career ladder, mayuse one program as a steppingstone to the next.

Ladders of opportunity.are especially important for minority groups, it was emphasized

by Montague Brown, as "these are the groups who can least afford to be boxed in. They are

less likely to be able to get back into school and go up a ladder outside the job structure."

Recommendation 14: Representatives of medical laboratory disciplines should initiate efforts witheducational testing specialists to develop equivalency tests to provide increasedmobility between levels and categories of laboratory careers.

Equivalency tests would make it passible for individuals to obtain science credits needed

for advancement through recognition of self-study, experience, maturity, and skills gained

on the job. Construction of adequate equivalency testing instruments would be facilitated

by the basic study defining essential skills for the categories of laboratory employment.

Methods developed to equate experience with education and training can be used toevaluate correspondence, television, and continuing education courses as well as to enable

graduates of Armed Forces laboratory programs to enter college or medical technology

training without meeting traditional academic requirements.Efforts should be made to insure recognition of equivalency tests by boards of certifying

and licensing laboratory personnel, and for admission to and advanced standing in colleges

and universities.Development of equivalency tests would enhance the appeal of laboratory careers.

The recognition of knowledge gained outside of formal education to fulfill academic

and clinical requirements would give persons with initiative and ability opportunities for

advancement.

LICENSURE, CERTIFICATION, ACCREDITATIONWhat you must decide is whether you prefer State or Federal controls, because some kinds

of controls obviously have to come. The question is simply, what system of control makes

sense? ELI GINZBERG) PIL D.

Recommendation 15: The agency administering a licensing program fa: clinical laboratory personnelshould have an advisory board of representatives of the scientific disciplines in-volved as well as knowledgeable representatives of the public.

Professions affected by laws and regulations should actively participate in their develop-

ment. Anticipating licensing legislation, the professional societies and academic institutions

involved in the training of medical laboratory personnel and the State health departments

should seek closer cooperation and communication in order to better identify and assess

each other's views.It was suggested that State laws adOpt, as qualifications for licensure, standards estab-

lishedrby national medical and scientific organizations such as the standards used by the

AMA's Council on Medical Education in approving AMA-accredited schools of medical

technology. Standards should be flexible to keep pace with changing technology.

Licensure shculd apply primarily to individuals responsible for performing tests and

arriving at results requiring scientific judgment. Accordingly, only the professional staff of

medical technologists, laboratory scientists, and supervisory personnel should be included.

In furtherance of the primary objective of certification -and accreditationto maintain and

1 3

improve qualityemphasis should be on qualifying rather than disqualifying programsand persons.

Recommendation 16: Accrediting and certifying agencies should explore possibilities and ways of offer-ing their services to all schools requesting evaluation, and to graduates of non-accredited programs applying for certification.

Accreditation of schools serves the objectives of identifying qualified schools for thepublic and the profession, 4:,mulating the development of good educational standards, andprovidine a guideline for licensure requirements. Establishment of a universal accreditationagency for all schools and personnel desiring evaluation would facilitate achievement ofthese objectives and eliminate confusion caused by multiple registries and accreditinggroups.

14

REPORT OF THE CONFERENCE

EXCERPTS FROM SPEECHESOpening the conference, Donald R. Chadwick, M.D.,USPHS Assistant Surgeon General, and Director of theNational Center for Chronic Disease Control, observed thatcontrol of chronic diseases depends to a very large extent onexcellence in laboratory services, which in turn depends onfinding answers to the problems confronting the conference.These problems center on the training and utilization ofpeople who can work in medical laboratories.

Following Dr. Chadwick, Kevin P. Bunnell, Ed. D., asso-ciate director of the Western Interstate Commission forHigher Education, urged the addition of new dimensionsto medical laboratory recruitment programs. Pointing outthat the laboratory profession is "in the midst of a techno-logical and scientific revolution over which it will havecomparatively little controlbut which could radicallychange" it, he suggested that recruitment aim not only at newyoung students but at older aged groups, at persons withoutmoded technical skills, and at a broad manpower base notconfined merely to the "intellectually gifted."

Dr. Bunnell noted the failure to use womanpower to itsfullest advantage, and advocated new kinds of educationprograms and appeals to "accommodate the life patterns ofmarried women." He spoke of relevance as the key wordin all of education. The real challenge, he charged, "is tosee that the whole process from preprofessional trainingthrough continuing education, including recruitment and thepractice of the profession itselfthat the whcle process re-mains relevant to the changing world as it is continuouslyrevealed to us."

Leonard D. Fenninger, M.D., Director of the USPHSBureau of Health Manpower, opened the Thursday sessionswith definition and interpretation of the five conference ob-jectives. He suggested that the estimated error of 25 percentin laboratory determinations performed in the United Statescomes from laboratories that are "overloaded, understaffed,or where personnel arc inadequately prepared for the newdeterminatioss that laboratories are being called upon tomake." More successful recruiting, training, and utilizationof laboratory personnel he called "essential for the improve-ment of patient safety and patient care."

In his address, Eli Ginzberg, Ph. D., Director, Conserva-tion of Human Resources, Ctiumbia University, urged con-ference participants to make sure that in reaching conclu-sions, "you don't get stuck with the patterns that served. you

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well in the past, but develop' the flexibility to come out whereit makes sense to come out a decade hence." Sounding anoptimistic note, Dr. Ginzberg stated that "automation isgoing to redound to your benefit. The large medical institu-tions and hcispitals of the future will assist the economics andefficiencies of laboratories." They will also present a paradoxin that, according to manpower economists, skills ought tobe greatest where the workload is greatest, as in large labo-ratories, he noted. However, in the medical field, technologistskill in a small laboratory must be high to respond to thewide range of clinical testing required.

On the preponderance of women in medical laboratoryemployment, Dr. Ginzberg said, "It is not healthy for afield if 85 percent of its personnel are women." He pointedto the compressed salary range of about $6,000 to $7,500which "is not sufficient for a man who has a family," andrecommended restructuring the field to create a reasonablenumber of assignments and career opportunities paying$15,000 and more.

Other suggestions made by Dr. Ginzberg were: Recruityoung men with medical laboratory training who leave thearmed services, possibly by more flexible certification andpromotion procedures or by making it easier for them toobtain prerequisite academic credits; greatly expand careerladders in medical laboratories; establish a laboratory posi-tion of rank of assistant clinical director paying $15,000 to$18,000 to relieve overburdened directors of laboratories toobig and complex to be supervised without such help; directrecruiting efforts to the junior colleges, which he called"the fastest growing dimension of higher education in theUnited Staies," and to college-trained "mature women of32 or older" whose children have entered school; providescholarships to permit ambitious young medical technol-ogists to attend medical school to become physicians.

Dr. Ginzberg concluded: "To get clinical laboratoriesproperly staffed, properly supervised, properly managed isa problem. But I think it can be done. The big challengeyou face * * * the fact that the whole of American medicalcare, the whole system, is now wide open. Everything is inmovement."

Ivan L. Bennett, Jr., M.D., Deputy Director of the Officeof Science and Technology, Executive Office of the Presi-dent, predicted major changes in future laboratory tech-nology on the basis that "generally speaking, predictionsabout future technological developments, no matter how fan-

Dr. Wolf applauded the "desire to get together in thehealth field" by such organizations as the Association ofAmerican Medical Colleges and the American Medical Asso-ciation. In conclusion he pointed out that, "changing edu-cational patterns are not necessarily new techniques of edu-cation, but better application of existing techniques. Thereare no new, easy gimmicks to help us. We must revise oureducational objectives and take a fresh look at how toachieve them."

tastic they may have sounded when first uttered, have fallenshort of the fantastic reality that has come into being bythe time the future has finally become the present.' Hewarned that "the principal danger in the selection of goalsfor the future lies in the powerful and diverting temptationto indulge in * * * self-fulfilling prophecies ' particularlyif the prophecy does not conform with the best attainablegoals.

Dr. Bennett attacked fears about the possible takeover oflaboratory medicine by "conglomerate corporations other-wise unrelated to health care' as a question that should not"influence decisions about how the medical laboratory canmore effectively serve America's health needs," because itconcerns possible consequences, not purposes. In conclusion,Dr. Bennett urged conference participants to be "tough butflexible, to put some resilient steel into your conclusions andrecommendations."

Closer regard must be directed to the public's future healthneeds, stated George A. Wolf, M.D., provost and dean,University of Kansas School of Medicine, if for no otherreason than that the public, through government, now pro-vides majority support for higher education. "Freedom todo the job our own way can be lost if we do not producethe trained people the public expects," he said. Dr. Wolf'ssuggested changes in present educational practices included:(1) Health careers recruitment that is an eduCational func-tion not a sales job. "Recruitment should be an expositionof the roles which the various workers play in caring forthe patient, leaving the student to decide which role hewants to play." (2) A core health educational curriculumproviding "the sound base from which the student can stepinto advanced educational programs for one of the healthprofessions" and move sideward or upward as the studentdesires. (3) Improvement in teaching students not onlyhealth care skills, but substantive information and attitudes.He suggested exploration of self-teaching devicesbooks,film strips, teaching machines, closed-circuit TVas meansof saving valuable teaching time to communicate attitudesrather than techniques. "How to sterilize a syringe is differ-ent from making sure the syringe is sterilized before it isused on a patient," he commented.

EXCERPTS FROM SYMPOSIUMA panel of seven experts representing aspects of adminis-tration and utilization of laboratory medicine addressedthemselves to and answered questions from the audience onmanpower for the medical laboratory and the eight relatedtopics assigned to discussion groups. Calvin Plimpton, M.D.,president of Amherst College, moderated and spoke foreducation.

Noting that "science is moving along," Dr. Plimptonnamed educating students to think as the surest methodof providing them career mobility. Training students todo something one way or to execute a procedure may sud-denly become irrelevant due to scientific changes, he ex-

plained, adding, "If on the other hand you have trainedthem to think, if you have really provided them with aneducation, they can move from one procedure to anotherand even from one profession to another * * * Hence Iam making a plea for education, not just about a particularsubject, but education for life as well."

Speaking of continuing ongoing education, he called ita "spirit quickening" that is the essence of helping peopleto grow while continuing to stay young. Commenting onautomation, he applauded its accuracy over manual methsof quantitative measurement, the relief it affords employeesfrom dull routine, and the fact that it makes work "livelyand frees people to be human beings."

Cc -qments of E. R. Jennings, M.D., director of the pathol-ogy boratory, Memorial Hospital of Long Beach, Calif.,w-te conce, ned with automation and licensing. Dr. Jennings,iircssed the opinion that "automation will create a need

for medical technologist: to be teachers and supervisors,to be better trained, )-o troubleshoot complex equipment,"rather than simply to do tests as they have in the past. But,he added, "not all our problems will be solved with auto-analyzers, robot chemists, and computers."

One need that must be met, Dr. Jennings said, is tliatdemonstrated in rural areas for extremely competent, well-versed, general-duty medical technologists. Other comingdevelopments he mentioned were intensive, bedside carerequiring a medical technologist in attendance 24 hours aday for the critically ill, and centralized, regional laboratoriesfor preventive medicine, induding detection of latent diseasein apparently well people. Speaking of licensure, he offeredthe opinion that "generally it has been a very good influenceon laboratory medicine" in California but that it has broughta certain amount of rigidity that is an impediment.

Leanor Haley, Ph. D., MT(ASCP), director, microbiologydepartment, State University Hospital, Brooklyn, N.Y., rep-resenting medical technology on the panel, agreed with Dr.Jennings that "the rote worker cannot do the work we aregoing to have to do in the laboratory." She criticized the pres-ent baccalaureate degree in medical technology as in many in-stances producing rote workers. She called it "not really anacademic degree, rarely recognized by any graduate schoolof reputable standing, and one of the reasons we lose peoplein the field" because it does not stimulate or challenge stu-dents. She approved the establishment of Colleges for AlliedHealth Professions, and expressed the hope that new experi-mental programs will emerge "because the medical tech-nologist does not come to us with a strong enough back-ground to set up many of the new procedures and carryout many of the teaching and supervisory responsibilitiesthat exist in the laboratory."

Ralph E. Thiers, Ph. D., director of clinical chemistry atDuke University Medical Center, representing clinical chem-istry, divided laboratory medicine into two distinct parts-60 to 70 percent quantitative in nature, the other part qualita-tive, requiring judgment and educated experience. The im-

yressive advances in laboratory medicine have been in thequantitative aspects, he said, but have not made substantialinroads on the subjective, qualitative work of laboratories.

The central and regional laboratories predicted for thefuture have proved best suited to quantitative laboratorytasks, Dr. Thiers stated. He added that increases in thistype of laboratory structure will siphon off more technologistsinto the quantitative areas and create even more acute short-ages of personnel to do the qualitative work.

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He suggested as an approach to the solution of this problemthe recruitment of chemists and other scientists interestedin "improving the analytical results from quantitative instru-ments and methods," rather than in patient-related activities.He added that "these scientists are almost wholly unawarethat they are needed in the clinical laboratory," and shonldbe made to feel welcome.

Dr. Thiers recommended reappraisal of present trainingprograms in light of automation advances to ensure that thepeople who put the samples in the equipment receive ap-propriate training, and those who do the supervision areproperly trained to supervise.

Speaking as a health planner, Stanley Olson, M.D., di-rector, Tennessee mid-South regional medical program, ex-plaiwd the primary goal of regional medical programs asimproving patient care in heart disease, cancer, and stroke.To the question of how leverage can be exerted to effect suchimprovement, Dr. Olson stated that the programs will pro-mote cooperation between educational institutions and thecommunity institutions where care is given, so that the twocan more effectively serve the physicians' and the public'sneeds. The programs will also provide funds for research ineducational procedures and in patient care, and will evaluateall projects to determine whether in fact patient care isimproved.

Representing a physician user of laboratory services, BlandCannon, M.D., member of the American Medical Associa-tion's Council on Medical Education and its Committee onAllied Health Professions and Services, said that physicianswant "instant" and "accurate" laboratory service. This re-quires competent laboratory personnel and, to assure it,continuing education, reassessment, reevaluation, and 're-certification. He pointed out that the health industry hasbeen creative in developing new technological advances, butslow to use them widely. Now, h.t said, "a change has startedthrough automation procedures and multiphasic screening."

As a "community user of laboratory services," GeorgeJames MD., dean of New York City's Mount Sinai Schoolof Medicine, recommended that laboratory services be moreconcerned with what people need than what they ask forat the moment. "If you realize that our major hope for thefuture is to pick up conditions when they are still at therisk or early presymptomatic stage, you will see that thereis much work in your future in gearing your services to meetthese needs, both in nsearch and in service." He deplored theseeming emphasis at present, on quantity in laboratoryprocedures over qt;ality.

Speaking fOr hospital administration, Montague Brown,dire-tor, Hospital Research Education Trust of New Jersey,noted that hospital administration personnel are movinginto management positions in clinical laboratories, and saidthat medical technologists may have to pursue higher de-grees in management. He foresaw the development of large-scale organizations for laboratory work as well as for otherservices delivered to community hospitals, and in this con-nection expressed concern for rural areas where highlyqualified general-duty personnel are needed. He mentionedthe hope that the type of people who like to run a country-store type of operation may fill this manpower need. Makinga plea for more effective career ladders in clinical laboratories,Mr. Brown called for special efforts for minority groupswho usually start at the lowest level of laboratory jobs and arethe ones "who can least afford to be boxed in' because oflack of educational opportunities.

THE DISCUSSION GROUPSConference participants were divided into eight separategroups for afternoon and morning sessions on eight questionsrelated to manpower for the medical laboratory. Because ofthe interrelationship between the questions, discussion fre-quendy ranged across borderlines from assigned topics torelated ones. Some of the following brief, condensed reportsreflect multigroup discussion.

On the topic, "Needs and Potential Sources for LaboratoryPersonnel," it was concluded that while future personnelneeds cannot be aecurately projected, it is probable that twiceas many laboratory workers as are now employed will beneeded in a decade. The two principal levels of need, thediscussion group felt, will be for highly trained specialiststo do complex tasks and for subbaccalaureate personnel to dolarge-volume testing, generally automated. Obtaining thispersonnel will require intensified recruitment efforts directedto students at all levels, to personnel leaving military service,married women seeking to return to work, the disadvantaged,and to the parents, teachers, counselors, and others who in-fluence choices of careers.

Discussing "The Impact of Automation and Other Ad-sances on /Technology and Science," participants agreed thatlaboratories today are only on the threshold of automationand computerization. More advanced application awaitsAvailability of more computer and other specialists. Just as*present laboratory personnel has been able to adjust tri thecurrent rate of automation, so will future laboratory em-ployees adapt to future changes, perhaps with the help ofstronger science and specialized courses. It was thought thatgeneral-duty, nonspecialist personnel at baccalaureate and atsubbaccalaureate levels will continue to be needed both forsmall, nonautomated laboratories and as manpower poolsfrom which specialists will be recruit-d. Continuing educa-tion and retraining courses will be essential to the introduc-tion and use of technological advances.

It is not possible at present to objectively evaluate "TheRole of Ccatinuing Education in Keeping LaboratoryWorkers up to Date," it was felt, because of the lack ofaccurate evaluation techniques. Participation in continuingeducation could be increased by establishment of continuingeducation programs in laboratories, improvement in present .

continuing education offerings, rewarding enrollment bysalary and other benefits, and enlightening laboratory direc-tors and administrators on the values of continuingeducation.

The conclusions reached on "Mobility through tquiva-lency and/or Education" were that mobility between thelevels of medical laboratory personnel can and shou/d be in-creased. Means suggested for bringing this about were devel-opment of strong, basic, health care courses for the varionslaboratory careers improvement of laboratory education andtraining across-the-board, and development of methods ofmeasuring and giving equivalent credit for experience andtraining. It was pointed out that instruments to measureequivalency would require, first, detailed analysis of labora-tory job requirements and, second, extensive developmentalefforts by testing and laboratory experts working closelytogether.

It was concluded by those discussing "Certification andLicensure of Medical Laboratory Personnel and Accredita-tion of Schools " that while both licensure and certification(the latter defined as voluntary registration) are desirableand meet different needs, neither can guarantee high per»

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formance. However, licensure a based on sound law effec-tively enforced and assisted by advisers representing both thedisciplines involved and the public, can come nearer to main-taining standards than can voluntary programs. Most be-lieved that licensing should be confined to the medical tech-nologist and other professional and supervisory categories.Although formal education was judged the surest means ofassuring quality performance, it was agreed that other quali-fications could also serve as criteria. The possibility was sug-gested of having the established accrediting agencies offertheir services to all schools submitting programs for evalua-tion, rather than only to those conforming to certain stipula-tions, as a way of eliminating public confusion over self-ordained registeries.

Discussioa ori "The Effects of Central, Regional, and OtherEmerging Laboratory Structure Patterns on Education,Training, and Utilization of Medical Laboratory Personnel"reached agreement that most future job opportunities arelikely to be in (1) centralized, (2) regional, (3) reference,(4) small local laboratories, (5) intensive care or accidentfacilities. It was concluded that top laboratory positions willrequire increased competence as gained in advanced coursesin automation and technology and in master's degree pro-grams. There will still be need for generalists, particularlyin small laboratories, and for post-high-school personnel asin operation and maintenance of equipment. The group heldthe opinion that automation is likely to improve opportuni-ties for advancement and diversification at the top levels butto reduce mobility for those at lower levels. It was felt thatincreased use of automation would produce more incomewhich in turn would increase remuneration for personnel,which would have the effect of attracting more men to thefield.

Those considering "Strengthening the Education andTraining of Laboratory Personnel," concurred that educationof laboratory personnel should be centered in institutions ofhigher learning, leaving to the clinical laboratories the provi-sion of clinical experience for students in academic programs,as well as dn-the-job training of their own personnel. Two-year colleges were named as educational institutions of greatpotential influence and the importance of working with themto devise acceptable programs was stressed. In this connection,facilitating transfer of academic credits from junior colleges

to baccalaureate, as well as from baccalaureate to graduateprograms, was advised.

It was suggested that medical technologists should havestrong 4-year baccalaureate education followed by or inte-grated with hospital internships, possibly of only 3 to 6months; that the Board of Schools consider abolishing clock-hour requirements and substituting other measures of com-petency; that development of a common-core curriculum forstudents in health fields be explored; that teachers of labora-tory personnel be given proper training and ample time tofulfill their teaching responsibilities.

In regard to "The Influence of Sociological and EconomicFactors in Choosing Medical Laboratory Careers," sociologi-cal factors that influence career choice were named as theindividual's school environment, peer influence, and parentalattitudes. Wokk conditions, the public image of the medicaltechnologist, and the career itself were also judged influential.Economic considerations believed important were opportu-nity, individual recognition, competent leadership, ialary,and pmfessionalism defined as a desire to be of service. Itwas suggested that opportunities for growth and advance-ment are of equal or more importance than salaries, and thatboth beginning and ceiling salaries should be of a level toattract both men and women to the field for lifetime careers.

THE CONGRESSMAN'S REMARKSIn a dinner address on health legislation and its effects onmedical. laboratory manpower, Congressman Paul G. Rogersof Florida characterized the conference as having "a problemof three dimensionsproducing more manpower to fill thealready existing manpower gap, establishing a program forincreasing this number as technology requires more man-power, and developing a system of retraining those we haveto match the ever-changing technology of the laboratory andmedicine."

He added, "I commend you for this meeting. I sincerelyhope there will be other such meetings where men of differ-ent disciplines will meet to discuss the problems common tothe entire spectrum of the profession."

The Congressman effectively summarized both the prob-lems posed for the conference and the objectives envisionedfor it.

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ALPHABETICAL LIST OF PARTICIPANTS

H. S. Aijian, M.D.Methodist Hospital of Southern CaliforniaArcadia, Calif.

Robert M. Alway, MD.Stanford UniversityPalo Alto, Calif.

Patricia A. Amos, MT(ASCP)University of Alabama Medical CenterBirmingham, Ala.

William AndrewsMemorial Hospital of Wake CountyRaleigh, N.C.

J. Lynn Arbogast, MD.Indiana University Medical CenterIndianapolis, bd.Camille Atwood, MT(ASCP)Norfolk General HospitalNorfolk, Va.

Elizabeth B. AustinSacramento State CollegeSacramento, Calif.

W. Robert Bailey, Ph. D.University of DelawareNewark, Del.

Elwood E. Baird, MD.University of Texas Medical BranchGalveston, Tex.

Myrton Beeler, MD.Louisiana State University Medical CenterNew Orleans, La.

Albert BelskieEditor, Nursing and Health OccupatiqnsEnglewood Cliffs, N.J.

Ivan L. Bennett, Jr., M.D.Executive Office of the PresidentWashington, D.C.

Ellis Benson, MD.University of MinnesotaMinneapolis, Minn.

Nellie May Bering, MT(ASCP)Oscar B. Hunter Memorial LaboratoryWashington, D.C.Maj. Gen. Joe M. Blumberg, MC, USAU.S. Army Medical R. & D. CommandWashington, D.C.Howard L. Bodily, Ph. D.State of California Department of Public HealthBerkeley, Calif.

Alfred Borg, Ph. D.National Science FoundationWashington, D.C.

F. Well; Brason, M.D.Harrisburg HospitalHarrisburg, Pa.

Mary Breen, MT(ASCP)University of VermontBurlington, Vt.

Joan Broekhoven, MT(ASCP)ASMT national recruitment chairmanNew Orleans, La.Marion M. Brooke, Sc. D.National Communicable Disease CenterAtlanta, Ga.

Carol BrownColumbia UniversityNew York, N.Y.

Donald E. Brown, M.D.Hackensack HospitalHackensack, N.J.

Montague BrownHospital Research Education Trust of New

JerseYPrinceton, N.J.

Roma Brown, MT(ASCP)Bishop Clarkson Memorial HospitalOmaha, Nebr.Jerry BuckinghamNew York University Medical CenterNew York, N.Y.

Kevin Bunnell, Ed. D.University or ColoradoBoulder, Colo.

Bland Cannon, MD.Medical Arts PlazaMemphis, Tenn.

Richard 0. Cannon, MD.Vanderbilt UniversityNashville, Tenn.

Kathryn P. CarawayFlint Community CollegeF14::1, Mich.

Wendall T. Caraway, Ph. D.McHaren General HospitalFlint, Mich.

Margaret R. Carroll, MT(ASCP)Muni Valley HospitalDayton, Ohio

Donald R. Chadwick, M.D.National Center for Chronic Disease ControlU.S. Public Health ServiceArlington, Va.

Anna Cherrie, Ph. D., MT(ASCP)koward University College of MedicineWashington, D.C.

Robert Christie, M.D.Weeks Memorial HospitalLancaster, N.H.

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Sara Cicarelli, MT(ASCP)State University of New YorkBuffalo; N.Y.

Rex B. Conn, MD.West Virginia University Hospital Medical

CenterMorgantown, W. Va.

Robert W. Coon, M.D.University of Vermont College of MedicineBurlington, Vt.

Gerald R. Cooper, M.D.National Communicable Disease CenterAtlanta, Ga.

Rex D. Couch, MD.University of Vermont College of MedicineBurlington, Vt.A. De Bernardis, Ph. D.Portland Community CollegePortland, Oreg.

John P. Decker, Ph. D.Arizona State UniversityTempe, Ariz.

Betty Devon, MT(ASCP)Grady Memorial HosPitalAtlanta, Ga.

Frank Dickey, Ph. D.National Commission on AccreditingWashington, D.C.

William Dolan, M.D.Arlington HospitalArlington, Va.

Nicholas Duffett, Ph. D.Kansas State Department of HealthTopeka, Kans.

Russell J. Fliers, M.D.University of Kansas Medical CenterKansas City, Kans.

Anna P. Fygelson, LL.B., MT(ASCP)Legislative chairman, ASMTWashington, D.C.

Leonard Fenninger, MD.Bureau of Health ManpowerU.S. Public Health ServiceArlington, Va.

John E. Forney, Ph. D.National Communicable Disease CenterAtlanta, Ga.

Horace Frazier, MD.Meharry Medical CollegeNashville, Tenn.A. James French, M.D.University of Michigan Medical CenterAnn Arbor, Mich.

Ruth M. French, MT(ASCP)University of Illinois College of MedicineChicago, Ill.

Don C. FreyHealth Careers Council of IllinoisChicago, Ill.

Carolyn M. Gaston, MT(ASCP)Louisiana State UniversityBaton Rouge, La.

John Gerberich, Ph. D.Wisconsin State UniversityEau Claire, Wis.Eli Ginzberg, Ph. D.Columbia UniversityNew York, N.Y.

John T. Godwin, M.D.St. Joseph InfirmaryAtlanta, Ga.John L. Goforth, M.D.Board of Certified Laboratory AssistantsDallas, Tex.

Leanor Haley, Ph. D., MT(ASCP)State University HospitalBrooklyn, N.Y.

John R. HallBureau of Health ManpowerU.S. Public Health ServiceArlington, Va.Joseph Hamburg, M.D.University of KentuckyLexington, Ky.

Col. James L Hansen, MC, USAArmed Forces Institute of PathologyWashington, D.C.

jean L. Harris, MD.D.C. Department of Public HealthWashington, D.C.

John K. HarrisSystems Development Corp.Falls Church, Va.

Robert S. Haukohl, M.D.University of MiamiCoral Gables, Fla.

William J. Hausler, Ph. D.University of IowaIowa City, Iowa

Ruth I. Heinemann, MT(ASCP)Chairman, ASMT E. et R. Fund, Inc.Memphis, Tenn.Richard J. Henry, M.D., Ph. D.Bio-Science LaboratoriesVan Nuys, Calif.

Norman HollyBureau of Health ManpowerU.S. Public Health ServiceArlington, Va.

David HooverBureau of Health ManpowerU.S. Public Health ServiceArlington, Va.Robert C. Horn, Jr., MD.Henry Ford HospitalDetroit, Mich.

Ruth F. Hovde, MT(ASCP)University of MinnesotaMinneapolis, Minn.

Arline Howdon, CT(ASCP)Johns Hopkins HospitalBaltimore, Md.Oscar B. Hunter, Jr., M.D.Oscar B. Hunter Memorial LaboratoryWashington, D.C.

Tyra T. Hutchens, M.D.University of Oregon Medical SchoolPortland, Oreg.

Wesley G. Hutchinson, Ph. D.University of PennsylvaniaPhiladelphia, Pa.Rebecca Irving, MT(ASCP)Colby Junior CollegeNew London, N.H.Patisue Jackson, MT(ASCP)Georgia Department of Public HealthAtlanta, Ga.George James, M.D.Mount Sinai School of MedicineNew York, N.Y.

Mary F. James, MT(ASCP)University of Kentucky Medical SchoolLexington, Ky.

E. R. Jennings, MD.Memorial Hospital of Long BeachLong Beach, Calif.

Col. George W. Johnston, MSC, USAOffice of the Surgeon GeneralWashington, D.C.Joseph Kadish, Ed. D.Bureau of Health ManpowerU.S. Public Health ServiceArlington, Va.

Carol Kahler, Ed. D.St. Louis UniversitySt. Louis, Mo.

Alex Kaplan, Ph. D.University of WashingtonSeattle, Wash.

Britta L. Karlsson, MT(ASCP)Northeastern UniversityBoston, Mass.

Robert Y. Katase, M.D.U.S. Public Health Service HospitalBaltimore, Md.

Stanley S. KatzQuinnipiac CollegeHamden, Conn.Will...in Kaufman, MD.New York State Department of HealthAlbany, N.Y.

Thomas D. Kinney, M.D.Duke University Medical CenterDurham, N.C.U. Penni Kokko, M.D., Ph. D.National Communicable Disease CenterAtlanta, Ga.

Robert LampingHealth Training InstitutePittsburgh, Pa.

John Lang, Ph. D.George Washington UniversityWashington, D.C.Lucille Larson, MT(ASCP)Tacoma General HospitalTacoma, Wash.

Leslie Lee, MT(ASCP)Orange Memorial HospitalOrlando, Fla.Col. Claude K. Leeper, MC, USAFArmed Forces Institute of PahologyWashington, D.C.

Harold Levine, Ph. D.University of Illinois College of MedicineChicago, Ill.

Alvin L. Lewis, M.D.Michigan State UniversityEast Lansing, Mich.

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Israel Light, Ph. D.Bureau of Health ManpowerU.S. Public Health ServiceArlington, Va.Lillian Long, Ph. D.American Public Health AssociationNew York, N.Y.Michael Lubran, M.D.University of Chicago Medical SchoolChicago, Ill.Fred Lucas, M.D.University of Missouri Medical SchoolColumbia, Mo.

Athalie Lundberg, MT(ASCP)D.C. General HospitalWashington, D.C.

Elizabeth Lundgren, MT(ASCP)Florida State Department of EducationTallahassee, Fla.

Robert C. Lyons, M.D.Suburban General HospitalPittsburgh, Pa.William LyonsState Department of EducationAlbany, N.Y.

Jerome P. Lysaught, Ed. D.University of Rochester School of Medicine

and DentistryRochester, N.Y.

Colin McPherson, MD.Ohio State University HospitalColumbus, Ohio

Rosser L. Mainwaring, MD.Oakwood HospitalDearborn, Mich.

Bernard F. Mann Jr., MD.Hospital of St. RaphaelNew Haven, Conn.Vernon Martens, M.D.Washington Hospital CenterWashington, D.C.W. B. Mason, M.D.University of Rochester School of Medicine

and DentistryRochester, N.Y.

Lee Mayo, MT(ASCP)Memorial Hospital of Wake CountyRaleigh, N.C.

Richard McBee, Ph. D.Montana State UniversityBozeman, Mont.

Clarence A. McWhorter, M.D.Universky HospitalOmaha, Nebr.Samuel Meits, Ph. D.Children's HospitalColumbus, Ohio

E. L. Miller, Ph. D.Stephen F. Austin CollegeNacogdoches, Tex.

Catherine Milos, MT(ASCP)Vocational rehabilitation consultantOradell, N.J.

William MirengoffU.S. Department, of LaborWashington, D.C.

Margaret MooreUniversity of North Carolina School of Medi-

aneChapel Hill, N.C.Wendell A. Musser, M.D.Duke Univertity Medical CenterDurham, N.C.

Barbara Nagel, MT(ASCP)Medicare AdministrationU.S. Public Health ServiceWashington, D.C.Arthur NelsonTechnical F.ducation Research CenterCambridge, Mass.

John O'ConnorSoutheast General HospitalLos Angeles, Calif.

Stanley W. Olson, M.D.Mid-South Regional Medical ProgramNashville, Tenn.Richard E. Palmer, M.D.Alexandria HospitalAlexandria, Va.Thomas M. Peery, M.D.George Washington University gchool of Medi-

cineWashington, D.C.Maryland PennellBureau of Health ManpowerU.S. Public Health ServiceWashington, D.C.Martha Phillips, MT(ASCP)Regional Medical ProgramsU.S. Public Health ServiceBethesda, Md.Lewis W. PikeEducational Testing ServicePrinceton, N.J.Michael PilotU.S. Department of LaborWashington, D.C.Calvin Plimpton, M.D.Amherst CollegeAmherst, Mass.Alberta Plym, MT(ASCP)University of Colorado Medical CenterDenver, Colo.Helen PowersU.S. Office of EducationWashington, D.C.John R. ProffittNational Commission on AccreditingWashington, D.C.Rosalind RaskinU.S. Department of LaborWashington, D.C.Verna L. Rausch, MT(ASCP)University of MinnesotaMinneapolis, Minn.William J. Reals, M.D.St. Joseph HospitalWichita, Kans.Mary S. ReshU.S. Department of LaborWashington, D.C.William Reynolds, Ph. D.State University of New York Medical CenterAlbany, N.Y.Marjorie Robbins, MT(ASCP)Temple UniversityPhiladelphia, Pa.Henry Robinson Ph. D.San Jose State CollegeSan Jose, Calif.Elizabeth Robintcn, Ph. D.Smith CollegeNorthampton, Mass.Congressman Paul G. Rogers of FloriddU.S. House of RepresentativesWashington, D.C.

Sister M. Rosarii, MT(ASCP)Little Company of Mary HospitalEvergreen Park, Ill.

Willkim Ross, MD.National Center for Chronic Disease ControlU.S. Public Health ServiceArlington, Va.

Rebecca SadinNational Institutes of HealthU.S. Public Health ServiceBetheccla, Md.

Kathryn Schoen, Ph. D.Ohio State UniversityColumbus, Ohio

William K. Selden, Ph. D.Consultant on Higher EducationPrinceton, N.J.

David Seligson, M.D.Yale University School of MedicineNew Haven, Conn.Alice Semrad, MT(ASCP)Marquette University School of MedicineMilwaukee, Wis.

Guy SimmonsU.S. Public Health Service HospitalCincinnati, Ohio

Carolyn Slater, MT(ASCP)Mississippi Baptist HospitalJackson, Miss.

Captain Bruce Smith, MC, USNArmed Forces Institute of PathologyWashington, D.C.

Esther Smith, Ph. D., MT(ASCP)Michigan Siam UniversityEast Lansing, Mich.

Harry P. Smith, MD.American Society of Clinical PathologistsChicago, Ill.

A. Bradley Soule, M.D.University of Vermont College of MedicineBurlington, Vt.

Berenice StevensCalifornia Association of Medical Laboratory

TechnologistsOakland, Calif.

George P. Stevenson, M.D.Medical College of South CarolinaCharleston, S.C.

Wellington B. Stewart, M.D.University of Kentucky Medical SchoolLexington, Ky.

Jon V. Straumfjord, Jr., M.D.University. of Alabama Medical CenterBirmingham, Ala.

Walter S. StuddifordU.S. Department of LaborWashington, D.C.

Herman SturmBureau of Health ManpowerU.S. Public Health ServiceArlington, Va.

Patricia SussmanAmerican Hospital AssociationChicago, Ill.

Fred. C. SuttonCuyahoga Community CollegeCleveland, Ohio

A. N. Taylor, Ph. D.Chicago Medical SchoolChicago, Ill.

2 1

Ralph Thiers, Ph. D.Duke University Medical CenterDurham, N.C.Teresina B. ThompsonSpringfield Technical Community CollegeSpringfield, Mass.

Phyllis Thornton, MT(ASCP)Freedmen's HospitalWashington, D.C.

Victor N. Tompkins, MD.New York State Dcpartment of HealthAlbany, N.Y.

Merlin L. Trumbull, M.D.Baptist Memorial HospitalMemphis, Tenn.

Samuel Van Voorhis, MT(ASCP)Quin and Rarnstad ClinicBismarck, N. Dak.George P. Vennart, M.D.Medical College of VirginiaRichmond, Va.

Warren Wallace, MT(ASCP)Medical LaboratoryCasper, Wyo.

Theresa WilkinsU.S. Office of EducationWashington, D.C.

William Willard, M.D., Ph. D.University of Kentucky Medical SchoolLexington, Ky.

George Z. Williams, M.D.National Institute of HwithU.S. Public Health ServiceBethesda, Md.

Marjorie Williams, M.D.Veterans AdministrationWashington, D.C.

Ruth Williams, MT(ASCP)University of FloridaGainesville, Fla.

Thelma Wilson, MT(ASCP)Appalachian Regional HospitalBeckley, W. Va.

Charles H. Winkler, Ph. D.University of AlabamaBirmingham, Ala.

Martha Winstead, MT(ASCP)South Bend Medical FoundationSouth Bend, Ind.George A. Wolf, Jr., M.D.University of Kansas Medical CenterKansas City, Kans.

Henry L. Wollenweber, M.D.Medical Arts BuildingBakimore, Md.

Loula Woodcock, MT (ASCP)Scripps Memorial HospitalLa Jolla, Calif.

Ivor C. Woodward, M.D.Loma Linda UniversityLoma Linda, Calif,William G. Wu, P. D.San Francisco State CollegeSan Francisco, Calif.

tom,"

_

SPEAKERS, SYMPOSIUM MEMBERS,

DISCUSSION GROUP LEADERS

Spea4crs

Donald R. Chadwick, MD.Ivan L. Bennett, Jr., M.D.Kevin Bunnell, Ed. D.Leonard D. Fenninger, M.D.Eli Ginzberg, Ph. D.Paul G. Rogers, Congressman of FloridaGeorge A. Wolf, Jr., M.D.

Symposium MembersMontague BrownBland Cannon, M.D.Leanor, Haley, Ph. D., MT (ASCP)George James, MD.E. R. Jennings, M.D.Stanley Olson, MD.Calvin Plimpton, M.D.Ralph E. Thiers, Ph. D.

Discussion Group ModeratorsRobert C. Horn, Jr., M.D.Tyra T. Hutchens, M.D.Thomas D. Kinney, M.D.Elizabeth Lundgren, MT(ASCP)MAVerna L Rausch, MT(ASCP)MSWilliam Willard, MD.Marjorie Williams, MD.

2 2

Assistant ModeratorsPatricia A. Amos, MT(ASCP)MSMarion M. Brooke, Sc. D.Gerald R. Cooper, MD.Ruth French, MT(ASCP)MAStanley S. Katz, MABernard F. Mann, Jr., M.D.Catherine Milos, MT(ASCP)MAMary S. Resh

Resource Persons

Howard L. Bodily, Ph. D.Alfred Borg, Ph. D.Carol BrownRuth I. Heinemann, MT(ASCP)Norman HollyHarold Levine, Ph. D.Lillian Long, Ph. D.William LyonsJerome P. Lysaught, Ed. D.Michael PilotAlberta Plym, MT(ASCP)MSWilliam K. Selden, Ph. D.David Seligson, M.D.Harry P. Smith, M.D.Jon V. Straumfiord, Jr., MD.Walter S. StuddifordHerman SturmPatricia SussmanGeorge Z. Williams, M.S.Loula Woodcock, MT(ASCP)

U.S. GOVERNMOT PRINTING OFFICE: 1968 0-20-825